Provider Demographics
NPI:1730951930
Name:CREASY, KARLY RENAE (LMSW)
Entity type:Individual
Prefix:
First Name:KARLY
Middle Name:RENAE
Last Name:CREASY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33364 BOB SMITH RD
Mailing Address - Street 2:
Mailing Address - City:PARSONSBURG
Mailing Address - State:MD
Mailing Address - Zip Code:21849-2606
Mailing Address - Country:US
Mailing Address - Phone:410-546-3449
Mailing Address - Fax:
Practice Address - Street 1:212 W MAIN ST
Practice Address - Street 2:
Practice Address - City:SALISBURY
Practice Address - State:MD
Practice Address - Zip Code:21801-5006
Practice Address - Country:US
Practice Address - Phone:410-800-2169
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-10-23
Last Update Date:2023-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD30752104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker